Question 5#

Which of the following is TRUE regarding onabotulinum toxin A?

A. Was first used in urological terms for treatment of neurogenic detrusor overactivity
B. Is a temporary treatment and requires re-injections for sustained benefit
C. Takes effect immediately
D. Selectively inhibits post-synaptic vesicular acetylcholine release by cleaving SNAP-25
E. Is not licensed for patients with idiopathic detrusor overactivity

Correct Answer is B


Answer B

Onabotulinum toxin A was first used in 1988 for the treatment of detrusor-sphincter dyssynergia. The first report for neurogenic detrusor overactivity was by Schurch in 2000. It is a selective inhibitor of presynaptic vesicular acetylcholine release by cleaving the synaptosomal-associated protein 25 (SNAP-25). The effects are temporary lasting on an average of 6–9 months. Re-injections are equally effective. It is generally performed under local anaesthesia with a flexible cystoscope as a day case procedure. Whilst originally licensed in the UK for use in neurogenic detrusor overactivity, in 2019 it was licensed for use in idiopathic detrusor overactivity (NICE).